Mammalian target of rapamycin (mTOR) inhibitors may be associated with a number of toxicities including stomatitis. The mIAS scale is used to grade mTor inhibitor-associated stomatitis.
mTOR inhibitors include everolimus and temsirolimus.
Parameters:
(1) average oropharyngeal pain over past 24 hours on 10 cm VAS
(2) oropharyngeal mucosal changes
Parameter
Finding
Grade
pain
0
0
0.01 to 2.99
1
3 to 5.99
2
>= 6
3
mucosal changes
no erythema or ulceration
0
erythema without ulceration
1
ulceration < 7 days duration
2
ulceration with at least 1 lasting >= 7 days
3
A larger ulceration is more likely to persist.
Dose reductions in the mTOR inhibitors is usually only done when pain and mucosal damage is severe (both Grade 3).
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